Individual provider Active NPI

Donald Wesley Davies, MD

  • Specialist
  • Ada, OK
National Provider Identifier
1730214578
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
20556 Issued in OK
Practice address
430 N Monte Vista St
Ada, OK 74820-4610
Phone
(580) 332-6040
NPI assigned
Feb 22, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 20556 OK Primary

Addresses

Primary practice location

430 N Monte Vista St
Ada, OK 74820-4610

Mailing address

311 S 14TH PL
Ada, OK 74820-7135
Phone (580) 310-9827

Other names 1

  • Donald Wesley Davies Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041208000194 OK Practitioner - Diagnostic Radiology 0446221824

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
20556OKMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Jackson County Memorial Hospital Authority Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1730214578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 S 14TH PL",
            "city": "ADA",
            "state": "OK",
            "postal_code": "748207135",
            "telephone_number": "580-310-9827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 N MONTE VISTA ST",
            "city": "ADA",
            "state": "OK",
            "postal_code": "748204610",
            "telephone_number": "580-332-6040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIES",
        "first_name": "DONALD",
        "middle_name": "WESLEY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "OK",
            "license": "20556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DONALD",
            "last_name": "DAVIES",
            "middle_name": "WESLEY",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Ada, OK

Sources for this page

Verify at the official NPI Registry.